A nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is effective?

Choice A Reason: This is incorrect because hypervolemia is a condition of excess fluid volume in the body. A client who has an extensive burn injury is more likely to have hypovolemia, which is a condition of low fluid volume, due to fluid loss from the damaged skin and capillaries.

Choice B Reason: This is incorrect because metabolic alkalosis is a condition of high blood pH and high bicarbonate level. A client who has an extensive burn injury is more likely to have metabolic acidosis, which is a condition of low blood pH and low bicarbonate level, due to increased production of lactic acid and ketones from tissue hypoxia and breakdown.

Choice C Reason: This is correct because low hemoglobin is a common laboratory finding in a client who has an extensive burn injury. Hemoglobin is the protein in red blood cells that carries oxygen. A client who has an extensive burn injury may have low hemoglobin due to hemolysis, which is the destruction of red blood cells, or hemorrhage, which is the loss of blood.

Choice D Reason: This is incorrect because hyperkalemia is a condition of high blood potassium level. A client who has an extensive burn injury may have hyperkalemia in the early phase of injury, due to cell damage and potassium release, but it is usually transient and followed by hypokalemia, which is a condition of low blood potassium level, due to fluid loss and potassium depletion.

Choice A Reason: This is incorrect because a thrombotic stroke is caused by a clot that forms in a cerebral artery, usually due to atherosclerosis. It typically occurs gradually and does not cause a sudden, severe headache or seizure.

Choice B Reason: This is incorrect because an embolic stroke is caused by a clot that travels from another part of the body, such as the heart, to a cerebral artery. It usually occurs abruptly and does not cause vomiting or fever.

Choice C Reason: This is incorrect because a transient ischemic atack (TIA) is caused by a temporary interruption of blood flow to a part of the brain. It usually lasts less than an hour and does not cause permanent brain damage or loss of consciousness.

Choice D Reason: This is correct because a hemorrhagic stroke is caused by a rupture of a blood vessel in the brain, resulting in bleeding into the brain tissue or the subarachnoid space. It usually causes a sudden, severe headache, vomiting, seizure, and loss of consciousness. It can also cause elevated blood pressure, fever, and increased intracranial pressure.